2019 Novel Coronavirus (CoVID-19): Part XXIV
2019
Novel Coronavirus (2019-nCoV (first named); COVID-2019 (later named
disease); SARS-CoV-2 (final name of the virus causing COVID-2019),
COVID-2019 Pandemic:
September 1, 2021 update Part 24
Paul Herscu ND, MPH
Herscu Laboratory
Entering the third phase of this pandemic (Part 3 of 5)
A piece on effective natural therapies
Hello and welcome. It has been a while since I have written. We have just now arrived at the third phase, of my understanding of the 5 phase stages of this pandemic. I imagine many of you are feeling frightened, angry and frustrated, as well as simply confused. Things have not gone as well as they should have, as we are experiencing the next increase of incidence in the USA. The question is how to proceed from where we are. I am bombarded by questions from family, friends, patients and students. I would like to discuss several major aspects to help the general discourse. This is a difficult task as at this time as there are two paths, one for those who have been vaccinated and one for those who have not been vaccinated. As a result, I would like to break down the writing into 5 separate posts. They are:
1. A piece for those who have been vaccinated
2. A piece for those who have not been vaccinated
3. A piece on effective natural therapies
4. A piece on other pharmaceuticals
5. A short recap
Herein, I begin with the third piece, a piece on effective natural therapies:
Before I start discussing natural therapies, I would like to comment on an email I received. It was a kind, short, email, that said why am I equivocating on having people get the vaccine. I was a bit taken aback by this email, given the fact that I have been so clear about this, since even before vaccines were available. And also, from the hate mail, death threats, and insults I received (as well as the many, many, many, kind words and thoughts). I would say that I was pretty clear about getting the first shots last winter. I think the writer of that letter felt like I was not clear enough in the last post. She lost family members to this virus, and I think she believed I should perhaps not give any thoughts or word to those that were not vaccinated.
I feel deeply for her loss, and the losses in so many families, and it brings to light the difficulty in this epidemic where it is challenging to pay attention to all the different facets and easy to make errors in perception. My goal in the last post was less about people that are caught up in some political, or uneducated or misinformed moment, but rather to bring up important topics that may give people pause. And if we can actually have a reasonable conversation, I think we would all be better for it. I would like to give you one example of what I mean, to show some of the complexity.
After the last post describing the direction studies might take, a paper came out describing this exact concept. It’s not a perfect paper, but a very interesting one, which adds to our knowledge, even while it skips a few issues, which I am pretty sure means it will be used inappropriately. A study came out of Israel, showing that those that caught SARS-CoV-2 were much less likely to be reinfected, as compared to those who were vaccinated. In other words, if you caught the virus you were less likely to catch it again, as compared to those that were vaccinated. And there was a very, very clear difference in the two groups. Here is the paper. I am fairly sure that people who do not want to get vaccinated will mistakenly use this paper as justification as to why they do not want to get the vaccine and instead will want to get the virus instead. And the reason this is important to us, and not just Israel, is that in relation to this epidemic, Israel has a better vaccination rate and got to it earlier than the rest of us. Think of what is happening there as a foreshadowing of what will occur here in a couple of months. From this paper, I am fairly sure people are going to say that getting the vaccine is the wrong thing to do.
For these sorts of infections, that recur, there is no real surprise here. In all respects, and mostly, often getting a bug and having your whole immune system engage, is superior and should not surprise anyone. That is common, not the exception. That is what I tried to say in the last post when I described the whole intricacy of the immune system, and how T killer cells and other parts of the immune system, working in concert, often do a better job than just having one component, like that stimulated by the vaccine, go at it. So, no surprise here. Just confirmation. This is similar to the point made before of those who contracted SARS had a much more robust protection and response to COVID-19.
There are other parts to the paper that I found troubling. For example, not being able to test antibodies to see who was reinfected, yet asymptomatic, and therefore not counted. Also, as a retrospective study, they were unable to look at the other immune components, or even look at behaviors that might have confounded the results. For example, it is known that people who got vaccinated also changed public health behaviors compared to those who did not take the vaccine. This is a problem with retrospective studies. They are very important, but just a part of the research that needs to be done. Other problems exist as well, as, for example, you could not include the people that died from the virus in this study. You are only including the people that lived. It is like dropping a bomb somewhere, not counting the dead and severely wounded, and saying that hearing loss in one group is better or worse than in another group. But what about the dead and severely wounded? See the problem? If you only look at a part of the story, at any one time, you are likely to have an incomplete assessment. Currently, today, about 20% of Israelis are not vaccinated, and they account for half of the seriously hospitalized patients. Currently, the vast majorities of ICU’s in the USA that are filled to capacity are filled with unvaccinated people. Yes, this will change, as the epidemic changes, but let’s not forget the misery that is upon us at this moment in time.
The biggest problem I have with the study relates to one part of the methodology. I would have liked to know the severity of illness that these individuals went through when they first had COVID-19. For example, if they barely survived and now do not get reinfected but are dealing with lifelong problems, that somehow sits differently in my mind compared to someone who got vaccinated and now has a breakthrough case with mild symptoms. You see what I mean. We just don’t know. We don’t have enough information from this study. In other words, this study, while important, is missing the most important data.
There was however one point that I thought was incredibly important that was not really made much of in the paper, and I am fairly sure will not be highlighted by those that do not want to get a vaccine. One of the arms of the study was to look at people who got the COVID-19 AND later got the vaccine also. And what it showed is that these people had the best results of all. This supports the hypothesis I shared in the last 2 posts. That if you could somehow, while very protected, catch the virus, (DO NOT DO THIS ON PURPOSE PLEASE—hopefully such a study will be taken up in a controlled setting to prove the concept is valid and can be done without putting people in harm’s way.) you might be better off than just taking the current vaccine or just getting the virus itself. This is what I meant by trying to work out how to operationalize and scale such an effort.
There are an additional three points not highlighted. The first is that they also looked at those that were infected and they saw that over time, they too were losing the benefit of having been infected, that the protection is not stably, but also has a time horizon. The second point is that the booster program is under way in Israel. It will probably be taken by a large proportion of older individuals. What is interesting is that it once more seems to be stemming the tide of illness severity, as is being currently reported. The third point is the one made last time, about time as a factor. All of these reports are based on what we know today, on the virus/vaccine/immune response, but can only describe what is seen at this moment in time. Our immune response changes over time. The virus changes over time. What we see as results today, will most assuredly be fairly different as the pandemic progresses to the next stages and winds down.
The fourth point is the most important one and it was not mentioned at all in the study. Odd but true. If you take ALL the individuals in the study, those who had previously been vaccinated, or those that had previously caught the bug, or those that previously caught the bug and then got vaccinated, if you take all of them, at this time, only about 1% or so get reinfected. And as importantly, no one died. In other words, they buried the lede here. One of the most important things we see in this study and I have seen in my clinic is that people who have to reengage with the virus, seem to have a pretty good survival rate. To me this is fantastic news, and is heralding the next stage of the pandemic. I will get back to this later and in the next posts, but basically, we are potentially getting a peek into what the future might look like, with severity of illness lessening.
I start with this story, of this letter from a reader, because I wanted to underscore that this is not an easy, simple topic, that there are reasonable people who, away from all the craziness, have legitimate questions, that should be asked and answered in both thought and ongoing investigation. I think this Israeli study does show that there is a way through.
*****
Now to move on to the main purpose of this post, natural therapies.
An overview of natural therapies in this pandemic
Let me start by stating this disclaimer, that while there are many trials, and many studies, THERE ARE CURRENTLY NO NATURAL PRODUCTS THAT THE FDA CONSIDERS AS BEING ABLE TO BE MARKETED FOR THE TREATMENT OR PREVENTION OF COVID-19. ALSO, WE DO NOT SELL ANY PRODUCTS, WE DO NOT SELL PRODUCTS THAT WILL BE DESCRIBED HERE. AND LASTLY ALL PRODUCTS DESCRIBED HERE ARE INEXPENSIVE AND CAN BE FOUND AT HEALTH FOOD SHOPS UNDER NUMEROUS LABELS. ALSO, I AM NOT CURRENTLY TAKING ANY NEW PATIENTS AS THERE JUST IS NO TIME, SO THIS IS JUST INFORMATION TO SHARE. That said, while all of these are studied, these studies are not proof, in the methodical fashion the FDA would want them. Think of these as helping support the normal functioning of the body. OK, I trust that is enough of a clear disclaimer!
I did not know what to call this, so I called this, previously, Plan B. In considering that this virus is going to be with us for the foreseeable future, and considering what current vaccines can and cannot do, and considering that people might not take the vaccines, which might accelerate transmission, accelerate mutation, and have a potential disaster with boosters, coming up with a second plan made good sense.
More specifically, as seems to be the case, it seems as though trying to get people to take the vaccine AND at the same time bolster the rest of the immune system might have to be the game changer. It seems as though we have arrived at this point now, part of the 3rd stage in the pandemic. As you may recall, originally the only discussion beyond public health efforts, coming from our government and medical institutions was around vaccination. All other discussion around natural products was squashed. That will not be the case now. In this stage of the pandemic, it is going to have to be vaccine AND other things to help the immune system function at an optimal level. We are not yet at the 5th stage of this pandemic, but at that stage people get the virus, but it will not be a big a problem, as mortality and morbidity will decline. We just have to get us all there, all of us in one piece.
Before starting to describe many of the approaches to consider, it is useful to consider infections not as a binary yes/no but rather more as a progression of events. And again, keeping it as simple and straightforward as possible, you might think, leaving out the smaller details, in these categories:
1. Limiting exposure. Here I mean public health/behaviors
2. Limiting infection load
3. Killing viruses upon contact
4. Helping your immune system combat the virus
5. Managing a healthy inflammatory response that does not go overboard
6. Managing clotting issues
7. Assisting in recovery, post infection
A few decades ago Amy and I put together a list of supplements that we thought would be a reasonable list to help the immune system function as intended in these situations. We discuss these with our patients. We reprinted those at the start of this epidemic here. (Scroll down to “Prevention Strategies.”)
Amy also wrote a piece about modifying your risk, both preventing exposure but also if you have been exposed.
Aside from these, which are still the mainstays for helping the immune system function well, there are other issues to content with, as mentioned above. Zinc seems to help the immune system deal with viruses. But it also seems to help kill viruses on contact. Which is why people have been using zinc/propolis lozenges as a potential way to knock down the viral exposure that someone might have had had in their throat. This may be important as related to what we know impacts severity of illness, or viral exposure as one variable.
One problem that people have to this new virus is that when you get exposed to it the first time it takes days to mount a proper full immune response. By that time, the virus has multiplied a great deal. So, the larger the exposure is the more of a head start the virus has. Anything you can do you knock down the exposed amount of virus, it may impact the severity of the illness. While zinc in this respect has not been intensely and conclusively tested in COVID-19, it does make sense. Make sure though that you do not throw your zinc/copper ration off. In other words, if you are taking zinc long term as a preventive, be sure there is 1-2mg of copper in your zinc supplement or in a multivitamin. Please consult with a physician who understands supplementation for a more detailed, personalized treatment plan.
In terms of limiting exposure itself, aside from other public health measures there is one very natural direction that we should be studying. I will speak more on this in the next post, but basically, creating a barrier so the virus cannot enter us efficiently in the first place. And since the majority of exposure to this virus is through the upper respiratory tract, then creating an intranasal barrier to the virus itself may well help. This is not a specific product I am recommended, rather a direction for further research. This would not be simply using a netti pot or nasal lavage, rather a more targeted approach geared to the nasal cavity. AND DO NOT TRY THINGS ON YOU OWN AND HURT YOURSELF! One thing you can do is ask you provider if there is such a thing being developed. Your provider will ask their supplier and this will encourage industry to study this in earnest. As you know most of the time we focus on what to expect in the next weeks and months. This is just one example. Keep doing internet searches on this as I am fairly sure something in this realm will be developed shortly. BUT STAY SAFE AND DON’T DO ANYTHING NOT TESTED.
I thought and wrote here, on the topic of clotting issues as the driver of the worse parts of COVID infections. There may be certain tests that could be run to see your likelihood of heading in that direction, or in the severity of infection, such as serum ferritin, CD4 Panel, CRP, Lactate-dehydrogenase. These should be run routinely in people with moderate to severe cases. Some of these were tested initially, but less so now, during an upswing. My hope is that this sort of panel can be developed that is inexpensive and has a quick turnaround, so that we are better prepared for patients who are more susceptible in this realm. Until then, patients I have had that were in the most severe states, I prescribed homeopathy, but that is too a long a topic here. Homeopathy along with all the other natural and integrative approaches need proper testing with sufficient funding and relevant study design.
Regarding homeopathy and prevention of catching this illness. There are a couple of papers I coauthored on the topic. They involve a trial that took place in India. In short, during the early phase of the pandemic, India was suffering greatly, especially in Mumbai. A trial was proposed, funded and conducted with 2,233 subjects, into 6 arms, one group received placebo, one group received a nosode of the COVID virus, and several other groups received specific homeopathic remedies in other arms. Subjects in the nosode group had lower incidence of developing symptoms, fewer hospitalizations, and shorter number of days to recovery. This was a small pilot study, so we are not making much of it, except to show a proof of concept. A much larger study, with similar, but fewer arms, is currently under way. I am not involved in that one, do not know the study design, cannot vouch for it, but hope that it will conclude in short order, so that we can see the results.
Properly funded studies are the only way to let some natural products have a chance to show efficacy. We discussed this, as well as how to go about getting funding previously. If you are at an institution that wants to conduct these sorts of trials, seek funding though the government, as discussed in the second part, here.
One symptom complex that seems to be terribly common, and well, terrible, is cognitive issues with this virus. Some have had mild confusion, while others seem as though they went quickly toward dementia. This is both common and scary. One of the things I have used for myself, and my patients is extremely low dose lithium orotate. 1mg doses. In fact, in this low dose, this was one of the main ingredients of a combination product that I created for patients and colleagues. Lithia Basic. But to be able to talk about it here, I have closed the company and we no longer sell this this or any related products. Nevertheless, you can find in the health food stores, low dose lithium orotate. There is a website that I have for the history of Lithium in these low doses if you would like to read further. But after years, for me to be able to recommend it here, and not profit from it, I closed the manufacture, sale and distribution down. I do, believe that in the future this low dose lithium will be shown to be extremely useful in cognitive decline related to COVID and beyond.
Finally, to this list you can add quercetin, which has been studied and shows pertinent impacts related to COVID. You can read a great deal on this as well as other products here. A recurrent theme is this. There are many, many products in nature that show signals of efficacy in viral infections, in immune response, and yes, even in COVID-19. However, there is no actual mechanism in the USA to allow a natural product to become standard of care, for treatment, unless FDA/FTC allow this to occur. And this is not likely to occur unless large studies are conducted, and they need funding. Lack of funds and the lack of structure is keeping these readily available substances at the signal of efficacy and small study level only, rather than helping to round out the overall public health response.
We say, all of us, including the vaccine makers, and immunologists, and scientists, and public health authorities that we want a full and proper immune response. But then we do not put the funding behind the studies that will help support that desire. This is incredibly short sighted of us, as a population. Ideally, and hopefully, what we will show is that these natural products have a role in modifying the intensity of the infections, such that it helps us move towards the next stage in the pandemic. More on this in the last post. For the next one, we discuss drugs.
